Dissociative Identity Disorder and Plural Identity Lecture Notes

Flashcards covering the diagnostic criteria, etiology, differential diagnosis, and treatment modalities for Dissociative Identity Disorder and Plural Identity as discussed by Dr. Mitra.

Dissociative identity disorder (DID)

A condition whose DSM-5 diagnostic criteria includes two or more distinct personalities, each with a sense of consciousness and memory, accompanied by gaps in recollection of day-to-day events.

Prevalence of DID in adults

Occurs in $1\%-1.5\%$ of adults, though specific numbers for children and adolescents are not available.

Average timeframe for DID diagnosis

Patients may remain in the mental health system for five to 12 years before receiving a formal diagnosis of DID.

Memory gaps in PTSD

Memory loss that is often fragmented and specifically related to the trauma.

Memory gaps in borderline personality disorder

Gaps in recall that occur in the context of mood dysregulation, where some form of continuity is usually evident.

Alters

Independent personality states with distinct names and identities that can switch suddenly, sometimes accompanied by trance-like moments or rolling of eyes.

Kluft's four predisposing factors for DID

1. Learned ability to dissociate, 2. Traumatic childhood experiences, 3. Lack of stable external emotional support, and 4. The presence of independent alters.

Plural identity (Multiplicity)

A social media phenomenon not recognized in the DSM-5 where individuals ('headmates') are co-conscious of each other, remember daily events, and can switch consciously.

Internal family systems therapy (IFST)

A therapy modality since the 1990s positing that all people contain tribes of fully formed personalities ('parts') that ideally work together.

Three-pronged treatment approach for DID

1. Ensure safety and stability, 2. Confront and integrate traumatic memories, and 3. Integrate all identities into one and rehabilitate the person.

Dissociative Experiences Scale

A 28-item self-reported instrument tapping into absorption, imaginative involvement, depersonalization, derealization, and amnesia.

Dissociation Questionnaire

A 63-question tool measuring identity confusion, fragmentation, loss of control, amnesia, and absorption.

Difficulties in Emotion Regulation Scale

A 36-item self-reported measure of nonacceptance of emotional responses, impulse control difficulties, and lack of emotional awareness.

Eye movement desensitization and reprocessing (EMDR)

A modality used with different identities to reduce mood symptoms and strengthen the ego in DID patients.

Auto-hypnotic

A state many DID patients are considered to be in, making hypnosis a treatment with some efficacy.

Medication guidelines for DID

While SSRIs may help with mood or PTSD, there is no data to support using medication primarily for DID; benzodiazepines should be avoided.

In-network system

A clinical strategy where the provider talks with one personality (such as an adult alter) to monitor another personality (such as a child alter).